Iranian Journal of Otorhinolaryngology
Volume:21 Issue: 3, 2009

ntroduction: Cochlear implant has been established as effective option in rehabilitation of individuals with profound hearing impairment. As much of the studies about cochlear implants concentrated on aspects of speech perception and production, so we decided to study the quality of life of pre-lingual deaf children after at least 2 years of implantation. Twenty four patients’ parents in Fars Center were selected that had been implanted for at least 2 years and they filled the quality of life questionnaire. Three months later this questionnaire was filled again and results of two stages were analyzed. In part of assessments p-value shows significant change in parent’s satisfaction. They believe that they can be beneficial for their children and in another part of this study, parents believe that the children communicate better, but still they need special care to do school homework and they have some difficulties in articulation. cochlear implantation is associated with improvement in quality of life. The improvement is significant in aspects of social communications and happiness.

ntroduction: The aim of this study was to evaluate the efficacy of clonidine on intraoperative bleeding in middle ear microsurgery. This prospective double-blinded clinical trial was performed on 51 patients (ASA I, II), aged 15-60 year undergoing middle ear microsurgery. They were randomly assigned to receive either 200 micrograms clonidine per oral or placebo 90 minutes prior the operation in a double blind condition. Intraoperative bleeding was assessed on a four-point scale. Systemic blood pressure and heart rate were measured before and during surgery. Intraoperative bleeding, antihypertensive requirements, cardiovascular changes after intubation, post operative bleeding and reoperations were compared between two groups. Clonidine group had a better bloodless surgical field than placebo group (P<0.05). Intraoperative consumption of antihypertensive drugs to reduce bleeding were significantly lower in the clonidine group (P<0.05). Heart rate and blood pressure were lower in the clonidine group, but their differences were not statistically significant. There was no significant difference in post operative bleeding and the rate of graft failure (reoperation) between two groups. Clonidine as a premedication can provide a bloodless surgical field and can improve surgical visibility during microsurgery.

ntroduction: High level noises can induce many bad effects on people and probably the most significant effect is hearing loss. Most important part of otologic structure that affect is outer hairy cells of cochlea. Soldiers are one of the high risk groups that affect by explosion noises. This study was conducted on soldiers with normal hearing examined before and after gun shooting. Hearing level before and after gun shooting examined in both right and left ears in different frequencies. Hearing threshold evaluated by OAE and PTA methods and data analyzed finally. Hearing thresholds before and after gun shooting in right and left ears were different in ≥4000 HZ frequency but there is no difference in lower frequencies. Differences of hearing thresholds before and after gun shooting measured by OAE were also significant. Loud noise of gun shooting can adversely affect hearing on high frequencies.

ntroduction: Sinusitis is one of the differential diagnosis of asthma. Association of sinusitit with asthma can result in severity of the disease and treatment failure. This study aimed to determine the prevalence of sinusitis in under 12 year old asthmatic children. In this prospective cross sectional study, the prevalence of sinusitis was determined in 60 under 12 years old asthmatic patients (47 boys, 13 girls) according to clinical signs (headache, productive cough, post nasal discharge, purulent nasal discharge), and the graphy of paranasal sinuses. The data (age, sex, severity of asthma) evaluated in two groups of patients, with sinusitis and without sinusitis. The site of sinusitis and prominent clinical signs were determined in patients with sinusitis. The prevalence of sinusitis was 48.3%. There was no differences in sex distribution between two groups (P=42%). The mean ages were 6.9± 2.2yr in sinusitis group and 6.6±2.0 yr in group without sinusitis. The maxillary sinuses were the most abnormal sinuses in graphy (86.2%). The most prevalent sign was cough (55.17%). There were no differences in type and severity of asthma in the two groups. The prevalence of sinusitis is high in asthmatic patients. In the cases of persistent cough in asthma, sinusitis must be considered. We didn’t find correlation between sinusitis and severity of asthma but it must be considered in the cases of poor control of asthma.

ntroduction: Painful dysfunction syndrome of masticatory muscles is one of the most important causes of pain in orofacial region. Therefore, the aim of this study was to evaluate the prevalency of 40 variables related to this disorder. A total 39 patients (32 females, 7 males) with painful dysfunction syndrome of masticatory muscles were studied. Patients were evaluated for prevalence of age, sex, job, marriage status, masticatory muscles tenderness, maximum mouth opening, deviation, deflection, temporomandibular joint involvement, habits, parafunctions, mall occlusions, neck pain, headache, ear pain and previous history of jaw involvement. Mean age of patients was 35±13.32 years old and most common range of age was20-40, 51% were house wife and 74.4% were married. Other variables included: Clicking (74.4%), temporomandibular joint pain (54%), headache (46.2%), ear pain (41%), neck pain (35.9%), limitation of maximum opening (71.8%), class I mall occlusion (74.4%), cross bite and deep bite (25.6%), deviation (7.7%), deflection (41%), bruxism (56.4%), clenching (64.1%) Masseter and external petrygoid (85%) muscles of masticatoty muscles had higher involvement. Because of painful dysfunction syndrome of masticatory muscles has variable signs and symptoms, diagnosis and treatment planning may be very difficult, Therefore having more information about this disorder can help physicians to make best decisions.

ntroduction: The aim of this study was to identify variations of different segments of facial nerve in temporal bone. In this descriptive study that conducted on drilled bones in the temporal bone center of the Al-Zahra Hospital of Isfahan University of Medical Sciences, the landmarks of facial nerve in temporal bone were identified as separate variables and their distances from outer cortex of temporal bone and Henles spine and distances between different segments of nerve were recorded. In the 50 temporal bones dissected, the distance between the tip of incus short process to the cortex was 14.2±1.96 mm, the distance between the facial recess from the facial nerve to the cortex was 14.5±2.58 mm, the distance between the stylomastoid foramen to the cortex was 20.6±2.49 mm, the distance between the lateral semicircular canal to the cortex was 15.9±2.31 mm and the distance between the sigmoid sinus dome to the cortex was 14.08±2.83 mm. The mean length of tympanic and mastoid segments (2nd and 3rd segments of facial nerve) were 11.35±0.68 mm and 13.28±1.11mm, respectively. The mean lengths of segment of facial nerve and distant of landmarks from outer cortex of temporal bone are partially similar compared to those described in the western literature and text books, but different compared to eastern researches.

ntroduction:Acuterespiratory complications are common in patients with cervical spinal cord injury. These complications can increase mortality and morbidity rates. The aim of this study is to specify the complications after traumatic cervical spinal cord injury, management of these patients and to select the appropriate remedial and preventive measures. This study has been performed retrospectively in Shahid Kamyab ICU wards for 2.5 years in patient group with cervical cord injury. The severity of injury had been scored based on Frankel scoring. We completed the charts for clinical and neurological findings, the remedial ways and the results. Finally, statistical analysis has been accomplished. From 592 patients being admitted with spinal trauma, 61 cases had cervical spine injury. 27 patients (44.3%) had been hospitalized in ICU for respiratory problems. Methyl prednisolon succinate has been used only for 4 patients. There was not any difference in this group versus control group. 23 patients (85.18%) had been scored in Frankel A. Mortality rate was 11 cases (40.7%). Tracheostomy had been used for patients with prolonged intubation and respiratory infection. Respiratory complications after cervical spinal cord injury are common and are accompanied by numerous complications and even mortality. We can reduce the mortality and morbidity rates in these patients by paying attention to these complications and using the immediate and appropriate ways of treating.

ntroduction: Ectopic intrathorcic goiter in comparison with retrosternal goiter is a rare presentation of thyroid disease, it must be considered in differential diagnosis of mediastinal masses, that may induce serious signs due to compression of other structures. In this article we report a case with large ectopic interathoracic goiter and we review the literatures. Case Report: A 43 years old woman presented with cough and dyspnea during pregnancy (1.5 year before) she came after labor and she had history of thyroidectomy 14 years ago. Radiologic exam showed widening of mediastinum and solid mass in upper lobe of right lung that filled half of hemithorax. Right thoracotomy was done and the huge mass with adhesion to lung was resected. Pathologic exam reported a multi nodular goiter. Patient discharged 10 days later with good general health. Ectopic intrathoracic goiter is a rare diagnosis in mediastinal and intrathoracic masses and must be diagnosed and treated before serious complications arise. Surgical resection is curative.